Use of granulocyte colony-stimulating factors in patients with HIV-associated lymphoproliferative diseases receiving cytotoxic therapy: Experience of a research center

Aim. To study the efficacy and safety of prophylactic single administration of a fixed dose of Extimia® (INN: empegfilgrastim) and daily administration of filgrastim in patients with HIV infection and lymphoproliferative diseases (LPD) receiving chemotherapy (CT).

Materials and methods. The article presents the results of a retrospective analysis of medical records for 2022. The criteria for inclusion in the study were the diagnosis of LPD with HIV infection and the use of granulocyte colony-stimulating factor (G-CSF). Thirty relevant medical records were selected from the medical archive. All patients received CT, including high-dose CT, and required primary prophylaxis of febrile neutropenia (FN). Patients were divided into two groups: Group 1 (n=15) received the long-acting G-CSF Extimia® (INN: empegfilgrastim) for the primary prophylaxis of FN, Group 2 (n=15) received filgrastim, a short-acting G-CSF. The points of interest were the incidence of neutropenia of any grade, Grade 3-4 neutropenia, febrile neutropenia, and the incidence of neutropenia leading to a delayed course of CT and dose reduction. The frequency of adverse events associated with the studied therapy was analyzed.

Results. The majority of patients were diagnosed with Hodgkin lymphoma (11/30, 37%) and B-cell non-Hodgkin lymphoma (9/30, 30%). The mean age was 35 years. In 2 patients in the filgrastim group, PN occurred, which led to the delay of the following CT course. Due to the absence of neutropenia development, the next course of CT was not delayed in any of the patients receiving empegfilgrastim. The most common adverse events in both groups were mild to moderate ossalgia and myalgia.

Conclusion. The data from real-world clinical practice demonstrate a favorable safety and tolerability profile of G-CSF in patients with HIV-associated LPDs, with a tendency to have a better efficacy profile in the long-acting G-CSF group.